Medications safety is a significant health issue for the 2.7 million Australians who are aged 65 years and older and at increased risk of medication related harm such as adverse drug events.(1-4) Adverse drug events are frequently under-recognised and can be mistaken for symptoms requiring further treatment, which leads to prescribing cascades, or simply dismissed as an unavoidable consequence of ageing. The increased risk of medication related harm in older people is multifactorial, including factors such as drug-drug interactions, prescribing cascades, frailty, physiological changes and multiple comorbidities. (5, 6)
Deprescribing is an intervention that is acceptable to older people, with over 90% of older people across a range of settings stating that they would like to stop one of their medications if their doctor said it was possible.(7) However, deprescribing in clinical practice is a challenging process, (5) and health professionals consistently cite the lack of synthesised evidence or guidance as a barrier to deprescribing.(8) Deprescribing is not a decision that can be made in isolation, but rather requires careful consideration of many patient factors including the overall health, quality of life, goals of care, and adherence to the current medication regimen.(5) Existing resources that support health professionals to identify potential target medications for deprescribing include lists of high-risk medications and decision-aids.(9) Lists that identify high-risk medications in older people can prompt clinicians to re-consider these potentially high-risk medications. The lists do not require specialist in-depth knowledge, however, they are generalised, and do not provide specific advice or information on how to withdraw identified medications or how to monitor medication withdrawal.(9) These guidelines will support clinicians seeking to determine whether deprescribing is appropriate in cases of polypharmacy and potential overprescribing.The target audience for the guidelines are all health practitioners who work with older people to manage medications, particularly pharmacists and medical practitioners. The target population for these guidelines are adults aged 65 years and older. These guidelines provide guidance on when and how to deprescribe medication(s) for older people by detailing the required monitoring, withdrawal methods and describing what to expect during the deprescribing process.